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Montana politics, elections and legislative news

Greg Gianforte Splits With Trump On House Healthcare Bill

Greg Gianforte at his home in Bozeman in 2016
Eric Whitney
Greg Gianforte at his home in Bozeman in 2016

Yesterday I spoke with the Republican candidate for Montana's US House seat, Greg Gianforte.

ERIC WHITNEY: When we last talked to you about the House healthcare bill, last Thursday, that was the day the House passed the bill, at the time you told us you need a little more time to study it before you could say whether you would have voted for it. So, would you have voted for the House bill?

GREG GIANFORTE: You know, last week I would not have voted for it, because we don't have enough data yet.

The commitment I've made to Montanans is, although I do believe Obamacare is in a death spiral and needs to be repealed and replaced, I need to know that in fact it'll bring premiums down, preserve rural access, and protect people with pre-existing conditions.

At the point when the vote came up last week, and at this point, we don't have a CBO (Congressional Budget Office) score, and I can't make that guarantee to Montanans. So I would have voted against it.

EW: Also on the day that the House passed the bill, or I guess the day after was when the New York Times leaked audio from a call that they portray as with lobbyists, talking about the bill, and you said that you were glad that the House passed the bill. And some people are reading that as (you) saying two different things about the bill. Can you explain what you were saying?

GG: Sure, and my comments have been completely consistent. Actually, the word I used was thankful.

You know, there was a period there after the first bill that came up, that I said I would have voted against, not the one last week, but prior, where people thought healthcare reform was dead. And I thought that was a mistake, because I do think we need to repeal and replace Obamacare.

Montanans have seen their premiums just skyrocket. I was and am thankful that we're making progress.

This bill, I would not have voted for the one last week, but I am thankful that we're making progress on getting it. It needs to go off to the Senate, but again, the reason we got into this problem is somebody famously said, they had to vote for the bill to find out what was in it, and I just don't think until we have a CBO score, we should be adopting policy until we know its going to bring premiums down, protect rural access and protect people with pre-existing conditions.

EW: So you're thankful that the House passed this bill, but it's not a bill that you would have helped pass. Is that right?

GG: As an engineer, I need to collect the data and make a decision, and the commitment I've made to Montana is I will not vote for a bill if I'm not sure that I can guarantee to Montanans that premiums will come down, that there is rural access - is preserved, and that we can protect people with pre-existing conditions.

EW: You are an enthusiastic supporter of President Donald Trump, he was lobbying House members to vote for this bill. Do you think he was wrong to do that?

GG: Um - clearly this was a key tenant of his policy, it's part of the reason why he got elected. I think the administration and Congress needs to repeal and replace Obamacare. And I look forward to taking my engineering skills and my negotiation skills back to D.C. to represent the people of Montana.

EW: If you had a chance to talk to the President about this bill, what advice would you have for him?

GG: That's an interesting question. I think that there are unique issues in Montana, particularly around rural access.

You know, Obamacare was strictly insurance reform. If we want to get healthcare premiums down for Montanans, we've also got to look at prescription drug costs, we've got to look at price transparency, we've got to work on reducing frivolous lawsuits that drives up the cost of malpractice insurance, defensive medicine.

There's no silver bullet here. There's no one thing we're going to do that's going to fix all this. We need to look at all options.

EW: The House bill is now headed to the Senate. Montana Senator Steve Daines is someone who used to work for your company, have you had a chance to talk to Senator Daines about this? Or what would you like to see Senator Daines do to move this process along so that the legislation that comes out of Congress meets those three goals you talk about?

GG: We need to get the analysis from the CBO, and then we need to tune the bill to make sure we achieve those goals. The time when we sign bills and find out what's in them later is over.

EW: You said there's no one thing, and there's a variety of things that need to be done, but I wonder if you could in terms of the top of your list of three things - what needs to be done to the House bill, or can it be modified so that it does not result in premiums going up for Montanans?

GG: Well, we need to get the CBO score and see what it actually does to premiums. We had it the first time, it did not actually bring premiums down right away, it did over time. But Montanans are seeing premiums go up 50, 80 percent a year. There's one thing about Obamacare, it's not affordable, and it's putting health insurance out of reach for many Montana families. And that's why we've got to focus on specific steps here.

Insurance reform is part of it, but we also need to deal with drug costs, I think increased price transparency is really important. I think when consumers have more options, there's higher quality and there's lower costs.

And then I mentioned frivolous lawsuits. We can't just deal with insurance reform, we've got to look at dealing with the underlying healthcare costs as well.

EW: You talked about those astronomical rises in some peoples' insurance premiums, 50 percent or more, and I know that's true for some of the people shopping on Montana's exchange, people who buy in the individual market. I get my insurance through the University of Montana, and my premiums didn't go up by anywhere near those numbers you talked about.

Do you mind if I ask where you get your insurance, and whether you saw premium increases like that?

GG: I'm on - I believe I'm on a Blue Cross Blue Shield plan. My personal increase was 82-and-a-half percent this last year.

EW: And you had no other options? You couldn't shop for a similar policy where your premiums wouldn't go up that much?

GG: Well, it was just presented to me last week, and since then I've been on the campaign trail traveling this state, so that's my first priority.

EW: You say that protecting rural access is important, and when I talk to rural hospitals in Montana, they say that the Medicaid expansion in Montana has really gone a long way toward them being able to stay open, and to offer access to patients. And there are also 70-some thousand Montanans, many of them in rural areas, who because of Medicaid expansion now have access to the healthcare system. Do you think Montana's Medicaid expansion should stay how it is, or needs to be repealed or somewhere in the middle?

GG: I think better is always possible. But I've been very clear. We can't do anything to pull the carpet out from under people who've been put on this Medicaid expansion. I've personally toured a lot our critical access hospitals around the state, down in Dillon and Ennis, I've been in the hospital up in Havre, and I've heard exactly the same thing, Eric. These are the life blood of these rural communities, and if people can't get local healthcare, many of them can't live there anymore. So we've got make sure we maintain viability of healthcare in rural Montana.

EW: Does that mean you'd be in favor of keeping Montana's Medicaid expansion the way it is, or do you think it needs changing?

GG: I think better is always possible.

EW: You have any specific ideas for how the Montana Medicaid system in general, or how the Medicaid expansion could be made better?

GG: I've met with the (Montana) Hospital Association, I've met with the MMA (Montana Medical Association), I've toured these critical care access hospitals, and what I've committed to is, healthcare is such an important thing, what I will be doing is putting together a healthcare advisory board .I learned in business, the bigger something gets, the farther you are from the truth. I need to be hearing from patients, insurance companies, hospitals and doctors and I just think we need to collect the facts and hear from all sides. There's innovative ideas out there, and I'd be willing to collect those and then the ones that make sense, and work towards the end zone that we want, which is lower premiums, preserving rural access and taking care of people with pre-existing conditions, we'll implement them.

Eric, I'm going to have to wrap up here in a minute or two.

EW: I'd like to just ask you one more about that pre-existing conditions portion. I've heard folks who support the House bill say it both ways: That it protects people with pre-existing conditions, but it also give states a waiver to rescind that. Do you think the bill that comes out of Congress should include a waiver that would allow states to drop the pre-existing condition protection?

GG: I would not support any plan that doesn't protect people with pre-existing conditions.

Eric Whitney is NPR's Mountain West/Great Plains Bureau Chief, and was the former news director for Montana Public Radio.
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